From the Guidelines
To treat a chalazion, start with warm compresses applied to the affected eyelid for 10-15 minutes, 4-6 times daily to help soften the blockage and promote drainage. Gently massage the area after applying the warm compress to help express the blocked material. Keep the eyelid clean by washing with mild soap and water. Over-the-counter pain relievers like ibuprofen (200-400mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) can help if there's discomfort. Avoid wearing eye makeup or contact lenses until the chalazion resolves. Most chalazia resolve within 2-8 weeks with these home treatments. If the chalazion persists beyond 4-6 weeks, grows very large, affects vision, or becomes infected (showing redness, pain, and swelling), consult an eye doctor. They may prescribe antibiotic eye drops or ointment for infection or perform a minor procedure to drain the chalazion. Chalazia occur when meibomian glands in the eyelid become clogged with oil secretions, forming a small nodule that can grow if not treated properly, as discussed in the blepharitis preferred practice pattern 1.
Some key points to consider in the treatment of chalazia include:
- Warm compresses and gentle massage can help soften and express the blocked material in the meibomian gland.
- Keeping the eyelid clean with mild soap and water can help prevent infection and promote healing.
- Over-the-counter pain relievers can help manage discomfort associated with the chalazion.
- Avoiding eye makeup and contact lenses can help prevent further irritation and infection.
- If the chalazion persists or becomes infected, consulting an eye doctor for further treatment is necessary, as they may prescribe antibiotic eye drops or ointment or perform a minor procedure to drain the chalazion, as discussed in the blepharitis preferred practice pattern 1.
It's also important to note that chalazia can be a sign of underlying meibomian gland dysfunction (MGD), which can be treated with various therapies, including topical antibiotics, anti-inflammatory agents, and procedures such as intense pulsed light (IPL) therapy or meibomian gland expression, as discussed in the blepharitis preferred practice pattern 1.
In terms of specific treatment options, topical lotilaner ophthalmic solution 0.25% has been shown to be effective and safe in the treatment of Demodex blepharitis, which can be a contributing factor to chalazia, as discussed in the blepharitis preferred practice pattern 1. Additionally, in-office procedural treatments such as IPL therapy or meibomian gland expression can be effective in improving meibomian gland function and reducing dry eye symptoms, as discussed in the blepharitis preferred practice pattern 1.
Overall, the treatment of chalazia should focus on promoting drainage and healing of the blocked meibomian gland, while also addressing any underlying conditions that may be contributing to the development of the chalazion.
From the Research
Definition and Causes of Chalazion
- A chalazion is a non-inflammatory process that develops due to retained secretion of the meibomian or Zeis glands, presenting as a mass lesion of the eyelids 2.
- It is seen in all age groups and is one of the most common eye conditions.
Treatment Options for Chalazion
- Treatment of choice differs among clinicians and may include:
- Application of warm compress onto eyelids
- Lid hygiene
- Using local antibiotic ointment with or without steroids
- Injecting steroid solution into the lesion
- Surgical removal of the lesion by incision and curettage 2
- Other experimented methods include injection of botulinum toxin A, tarsal trephination, removal of chalazion by application of CO2 laser or cryogenic action 2.
- Conservative therapy, such as hot compresses, with or without tobramycin or tobramycin/dexamethasone, is also effective for chalazia treatment 3.
Effectiveness of Treatment Options
- A study found that hot compresses alone or in combination with tobramycin or tobramycin/dexamethasone drops and ointment are all effective first-line treatment options for chalazia 3.
- However, lesions that completely resolved had a statistically significant lower pretreatment duration (1.5 months) compared to lesions that did not completely resolve (2.2 months) 3.
- Intralesional steroid therapy proved equally effective in small, multiple, and marginal chalazia, while in large lesions incision and curettage scored better 4.
Risk Factors for Chalazion Diagnosis and Surgical Excision
- Risk factors for chalazion diagnosis include female sex, non-white race, northeast location, conditions affecting periocular skin and tear film, non-ocular inflammatory conditions, and smoking 5.
- Male sex, rosacea diagnosis, Black and Hispanic race, antibiotic use, and doxycycline use increased odds of surgery 5.